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Evidence summaries

Shock Wave Therapy for Lateral Elbow Pain

Shock wave therapy provides little or no benefit in terms of pain and function in lateral elbow pain. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 9 placebo-controlled trials with a total of 1 006 subjects. Eleven of a total of 13 pooled analyses found no significant benefit of extracorporeal shock wave therapy (ESWT) over placebo. Weighted mean difference (WMD) for improvement in pain (on a 100-point scale) from baseline to 4-6 weeks from a pooled analysis of three trials (446 participants) was -9.42 (95% CI -20.70 to 1.86). WMD for improvement in pain (on a 100-point scale) provoked by resisted wrist extension (Thomsen test) from baseline to 12 weeks from a pooled analysis of three trials (455 participants) was -9.04 (95% CI -19.37 to 1.28). Two pooled results favoured ESWT. Steroid injection was more effective than ESWT at 3 months after the end of treatment assessed by a reduction of pain of 50% from baseline (21/25 (84%) versus 29/48 (60%), p<0.05).

    References

    • Buchbinder R, Green SE, Youd JM, Assendelft WJ, Barnsley L, Smidt N. Shock wave therapy for lateral elbow pain. Cochrane Database Syst Rev 2005 Oct 19;(4):CD003524. [PubMed]

Primary/Secondary Keywords